<!--# include virtual="/admin/common/html/header.html"-->
<body>
<div class="page-container">
	<form action="" method="post" class="form form-horizontal" id="form-user-add">
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				省份：</label>
			<div class="formControls skin-minimal col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>省份</option>
				    <option value="1">北京</option>
				    <option value="2">天津</option>
				    <option value="3">山东</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				城市：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>城市</option>
				    <option value="1">北京市</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<!--<span class="c-red">*</span>-->
				县/区：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>县/区</option>
				    <option value="1">西城区</option>
				  </select>
				</span>
			</div>
		</div>
		
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				年月：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" onfocus="WdatePicker({ dateFmt:'yyyy-MM'})" id="logmin" class="input-text Wdate" style="width:200px;">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				信息价名称：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">篇：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>县/区</option>
				    <option value="1">西城区</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">章：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>县/区</option>
				    <option value="1">西城区</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">节：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>县/区</option>
				    <option value="1">西城区</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">专业：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>专业</option>
				    <option value="1">公路</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				材料名称：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				规格型号：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				单位：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<span class="select-box">
				  <select class="select" size="1" name="demo1">
				    <option value="" selected>单位</option>
				    <option value="1">kg</option>
				    <option value="1">m</option>
				  </select>
				</span>
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				含税价格：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				除税价格：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				最低价：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">
				<span class="c-red">*</span>
				最高价：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<input type="text" class="input-text" value="" placeholder="" id="user-name" name="product-category-name">
			</div>
		</div>
		<div class="row cl">
			<label class="form-label col-xs-4 col-sm-2">备注：</label>
			<div class="formControls col-xs-6 col-sm-6">
				<textarea name="" cols="" rows="" class="textarea"  placeholder="说点什么...最少输入10个字符" onKeyUp="$.Huitextarealength(this,100)"></textarea>
				<p class="textarea-numberbar"><em class="textarea-length">0</em>/100</p>
			</div>
		</div>
		<div class="row cl">
			<div class="col-9 col-offset-2">
				<input class="btn btn-primary radius" type="submit" value="&nbsp;&nbsp;提交&nbsp;&nbsp;">
			</div>
		</div>
	</form>
</div>
<!--# include virtual="/admin/common/html/_footer.html"-->
</body>
</html>
